Remember your school days when you would visit your beloved school nurse? She’d sit you down and take your temperature, regardless of whether you had a fever or a bruised knee, and return with a strip of magical tablets that made you feel better instantly. Years later, even when you were in your final year of school, it’s always been the same nurse and the same tablets with their omnipotent recovering power. What you notice here isn’t just a mere pattern of deceit, but a million-dollar industry working its charm.

Though the title of this article may inflict a pucker between your brows if you’ve got a medical degree gleaming on your shelf, the placebo effect cannot be denied as a hoax. It is real, effective, and here to stay.

A placebo is basically a substance or a treatment which is designed to have no therapeutic value. They can range from simple sugar pills and saline injections to (believe it or not) fake surgeries. However, the effect does not simply rely on the medicine alone. It also entails the carefully curated ritual of having to visit a medical professional in a white coat, the weight checking, urine testing, exchanging of your symptoms and family history, and so on. The process has proven to have quite a profound impact on your mind simply because you feel you are given attention and care.

(Could surgeries work through placebo effects too?; Courtesy: Sprouts on Youtube)

However, let’s get it straight- It’s not like placebos can magically lower your cholesterol or constrain the growth of a tumour. Placebos work on symptoms modulated by the brain and involve a complex neurobiological reaction that includes feel-good neurotransmitters, like endorphins and dopamine, to activate certain brain regions linked to moods, emotional reactions, and self-awareness. All of it contributes to the healing of the ailment. Further, since the placebo effect depends heavily on how readily and enthusiastically we respond to the treatment, we may also infer that certain personality traits are more likely to experience the placebo effect than others. Optimists are more responsive to certain placebos, while pessimists tend to need more coaxing.

(How attributes of pills contribute to the placebo effect)

This also follows that the warmth and confidence conveyed by the doctor plays a key role in the execution of the placebo. Studies found that subjective pain was lower after a medical procedure when participants thought they’d been paired with a doctor who shared the same values and personal beliefs as them. THIS is the problem with placebo - we let our perceptions guide us.

However, the placebo effect can’t be explicitly labelled imaginary or fake. Several findings show that there are actual physical changes that occur under placebo. For instance, in terms of athletic abilities, various studies have shown it’s effects on speed, strength, and endurance. Another experiment involved participants receiving “fake” non-invasive brain stimulation and performing a learning task. The placebo group thought their brains had been stimulated by a mild electrical current – in reality, they hadn’t – and they were led to believe that this stimulation would boost their mental function. The placebo participants were subsequently more accurate in the learning task and showed steeper reductions in their reaction times than the control group.

(The placebo sweet spot: Researchers conducted placebo experiments and scanned the participant’s brains with MRI. They noticed greater activity in the middle frontal gyrus brain region, which makes up about one-third of the frontal lobe.)

The bottom line is that although we know well that placebos are heavily correlated to psychological factors, we can’t deny that it is effective when it comes to pain relief, fatigue, and even sometimes curing depression. Unfortunately, science and research have still not figured the exact mechanisms in the body that are contributing to this effect. It seems like the more we try to comprehend and control the effect, the more the human body baffles us.

Shaheen Rafiq